ABSTRACT
Rh disease (hemolytic disease of the fetus and newborn; i.e., erythroblastosis fetalis) has also been the subject of treatment with IVIG. There is a controversy regarding administration of weekly IVIG to the pregnant woman with anti-D. The background for this controversy is described at least in part in the section on treatment of the fetus with alloimmune thrombocytopenia. One school of thought, voiced by Rewald and Suringar, is that MG is beneficial provided fetal blood sampling is not attempted. Sampling is likely to cause transplacental hemorrhage, and Rewald and Suringar feel that this may offset the IVIG effect (58). Our study of weekly maternal infusion of IVIG, which included fetal blood sampling, saw no benefit of IVIG treatment, unlike what we have reported in the parallel platelet disease, alloimmune thrombocytopenia (59). Unfortunately, without fetal blood sampling, it is extremely difficult to document an IVIG effect since the degree of fetal anemia is unknown and can only be the subject of speculation based on the previous sibling(s).
